Wednesday, 11 March 2015

An institution to be proud of

Mischievous rumours circulate from time to time about how the Wairarapa hospital is going to close. I hear these more often than I’m comfortable with and of course they are ridiculous. The Wairarapa simply couldn’t operate as a healthy modern society without its own hospital unless its citizens were all allocated Martin Jetpacks - and even then there would insurmountable complications.

Those heady days when we all put our hands around the hospital to “save” it was more about perception than substance. It was a great opportunity to show community solidarity on a balmy summers evening, but no government would ever consider closing a public hospital in an area as widespread as the Wairarapa.

Another ridiculous claim that you often hear or read about in letters or texts to the editor is that the hospital is being taken over by the Hutt Valley District Health Board. Again nothing could be further from the truth. We and the Hutt do share the one CEO, but the Wairarapa hospital has a separate in-house manager and its own fiercely independent district health board.

The Wairarapa DHB has seven elected board members. These include three doctors, a practising nurse, two ex-nurses and a butcher. There’s an odd man out here and I can’t for the life of me think who that might be. In health forums where we are unknown to our colleagues and have to make formal introductions I usually describe myself as an ex-surgeon and then lamely admit that I have only ever operated on beef, lamb and pork.

The government appoints four other board members, often to fill a skills gap. One of these is usually the chairman and our appointees include an ex-chief executive of a governmental science organisation, an accountant and a Maori gentleman. We originally had two of the latter, but one resigned to pursue life in a more public arena and we are expecting the announcement of a new appointee, rumoured to be a well-qualified Maori lady, imminently.

A few years ago the Health Department encouraged us to make closer linkages with our neighbours to the south in an endeavour to streamline services and contain costs. These relationships already existed of course, but are now more formalised and we meet regularly with the boards of Hutt Valley and Capital and Coast to discuss how we can continually improve the health outcomes of our respective communities.

Our compact 92 bed hospital in Te Ore Ore Road, in round figures, employs 200 nurses and 40 doctors. This may seem a lot, but this sort of staffing is required to keep a hospital open in a 24 hours a day, seven days a week, environment.

The hospital performs exceptionally well. The Ministry of Health sets targets for all of New Zealand hospitals and the Wairarapa Hospital invariably meets its targets or exceeds them.

Recently the new Minister of Health Jonathan Coleman, himself an ex general practitioner congratulated our team on the number of elective surgeries performed. For the last October, November, December quarter the target set was 443 elective surgical discharges whereas 55 more were performed - reaching almost 500.

The Wairarapa DHB’s other targets were either improved or remained stable.

The Achilles’ heel for the board is reigning in costs. We are looking at a deficit in excess of $2 million this financial year and this is unacceptable to the ministry. Also exacerbating our financial difficulties and not generally known is that although governments boast to the electorate when they build a new hospital, the actual cost of the hospital comes out of the population-based Ministry of Health funding.

Wairarapa’s new hospital is going to take decades to pay off and is therefore a constant burden on our income stream.

However the recent census has exposed that the Wairarapa has grown at a far greater rate than was initially forecast and in the upcoming financial year our funding will increase by $5 million.

Some of this income will be used for capital works that have been held over, but a break-even situation does look possible for the 2015-2016 years.

No need to put our hands around the hospital then, but you might like to put your hands together for the dedicated staff whose skills and endeavour have led the Minister of Health to concede that ours is one of the best performing hospitals in the country.

“My father invented a cure for which there was no known disease. My mother caught the cure and died of it.” - Victor Borge